Program creator Handysides says key to helping smokers quit will be personal relationships

The man seated in your pew must also be thinking about the smoking area because he just quietly slipped out of the building during the Sabbath sermon.

A few minutes later he returns, the strong scent of smoke clinging to his dark suit.

You smile at him and continue listening to the sermon.

No big deal.

This scenario is part of the vision of Breathe-Free 2, a brand-new stop-smoking program that the Seventh-day Adventist Church launched at a health conference in Geneva, Switzerland. The program is pinning its hopes for success on a combination of scientific research, an open-source website, and the personal relationships that participants develop as they take the course.

And it costs nothing.

“It’s free. It will always be free,” said Daniel Handysides, who spent three years developing Breathe-Free 2 and tested it in the United Arab Emirates.

The program has roots in Breathe-Free, developed by the Adventist Church more than two decades ago, and the earlier Five-Day Plan to Quit Smoking, first introduced in 1959.

But it uses a completely new approach because attitudes toward smoking have changed drastically in recent years, said Handysides, assistant professor of health at Loma Loinda University. Unlike in past decades, today’s smokers don’t need to be convinced that tobacco is bad for them and cannot be scared or lectured into quitting, he said.

“You cannot find a smoker in the world that does not know that cigarettes cause cancer,” he said in an interview Friday on the sidelines of the Geneva conference. "So our old model of lecture and fear doesn’t work.”

That meant new methods needed to be found to assist smokers, and Breathe-Free 2 is putting a special focus on personal relationships. While the program has a do-it-yourself version, it encourages smokers to join a local group where they can receive emotional support and, crucially, make new friends.

“If you smoke and your friends smoke, it means you have to give up you whole circle of friends,” Handysides said. “That’s a huge loss.”

There may be many circumstances that prompt a struggling smoker to light up, but the presence of other smokers, especially close friends, is a nearly irresistible temptation. No one wants to lose friends, of course, so Breathe-Free 2 invites smokers to bring their friends to quit and nurtures new friendships. New friends could include the local program facilitator and other members of the Breathe-Free 2 group.

Smoking Outside a Church

Many people who quit only succeed after seven to 10 attempts, and that’s why it is important to create a place where they can smoke outside church, Handysides said.

“It is my goal that every one of our churches will reach the point where they have smoking sections outside the church,” he said. “People should be able to feel comfortable coming to a Seventh-day Adventist Church as a smoker.

“We’re not wanting them to be a smoker,” he said. “But we should accept them right where they’re at, and be ready to work with them so that they can change and have a healthier lifestyle.”

The church that Handysides attends at Loma Linda University does not have a designated smoking area. Indeed, the entire campus is smoke-free.

Handysides said he understood that some churches might balk at the idea of smoking areas, and his proposal, in a sense, was metaphorical. "I'm talking more about an attitude shift in which we allow smokers to come into church facilities without judgment," he said.

Although rare, it is not unheard of for an Adventist church to create a designated spot for smokers. For example, the New Hope Seventh-day Adventist Church in Fulton, Maryland, has kept a freestanding ashtray outside its main entrance for years. A church member said he had never seen it used since he joined seven years ago, but church leaders do mention it in a standardized greeting to first-time visitors, which says in part: “We don’t want anyone struggling with nicotine addition to feel that they are not welcome.”

How Breathe-Free 2 Started

Breathe-Free 2 got its start when Loma Linda University asked Handysides to conduct Breathe-Free classes at military high schools in Abu Dhabi, one of the United Arab Emirates. The university approached Handysides after getting a request for the classes from a nongovernmental organization, the International Commission for the Prevention of Alcoholism and Drug Dependency.

Handysides wrote to the General Conference, the headquarters of the Adventist world church in Silver Spring, Maryland, for information about obtaining the course material. He learned that the General Conference was the sole publisher, and it printed the coursework on demand.

In short, the program was "antiquated," Handysides said.

So with the blessing of the General Conference, he and his wife, Sandra, a family nurse practitioner, led a revamp of the program into Breathe-Free 2 and tested the results for 18 months in Abu Dhabi.

Handysides said the success rate for Breathe-Free 2 is expected to be slightly higher than the 40 percent averaged by its two predecessors. No stop-smoking initiative has a rate topping 50 percent, he said.

Breathe-Free 2 only targets smokers who have a strong desire to quit because they have the best chance of success, Handysides said.

“We want people already in the action phase,” he said.

Part of the advantage of the new program is that all materials are available online at breathefree2.com. In addition, anybody can download, translate, and upload them back to the site for other people to use.

The program currently is only available in English, but a Spanish translation is scheduled for release in August. Tentative discussions have started on translations in Russian, Polish and Finnish.

Among the materials on the Breathe-Free 2 website is a world map showing the locations and contact details of the first 34 program facilitators and videos aimed at fostering group discussion and developing new friendships. The videos are only in English, but their scripts are available for download, allowing non-English groups to act them out or use them in other ways, Handysides said.

The first phase of the program takes eight days to complete and is followed up with a series of meetings over the next days, weeks and months.

“What’s important is establishing solid relationships that will go back and forth over the time that it takes to quit,” Handysides said.